The Grand Rapids Clinical Oncology Program (GRCOP) has achieved a national reputation for excellence in community cancer care through its 29-year participation in programs of the National Cancer Institute. In 2003, the GRCOP was highlighted by the NCI as one of 27 CCOPs continuously funded since 1983. The GRCOP comprises a consortium of nine health care systems/hospitals in Western and lower-Northern Michigan and seeks to continue to meet the community's need for innovative and relevant studies of promising therapeutic modalities and cancer controls research. The ongoing mission of the Grand Rapids Clinical Oncology Program is to assure that every person in the region served is provided an opportunity for participation in national cancer prevention and treatment clinical trials. Additionally, we strive to provide education about cancer and the NCI clinical trials program. This grant application encompasses and articulates an ever-expanding vision for the GRCOP. Key strategies to increase patient access and accrual to research protocols include: (1) expansion of on-site screening and patient identification for enrollment in research protocols;(2) development of a targeted clinical trials program for adolescents/young adults;(3) the addition of the Radiation Oncology Therapy Group (RTOG) as a research base, bringing the number of NCI research bases with which the GRCOP affiliates to 8;(4) partnering with NCI in its efforts to increase accrual of the elderly population to clinical trials;and (5) increased involvement by primary care providers and specialty physicians in cancer prevention and control protocols. Strategic initiatives to increase access to and participation in cancer clinical trials by underserved and minority populations incorporate alignment with community organizations throughout the patient catchment area, with an expanding focus on the growing Hispanic/Latino population. Of importance during this upcoming grant cycle will be the GRCOP's continued focus on improving the efficiency and cost-effectiveness of participation in clinical trials through expansion of its data management software system to include both a drug inventory management module and an IRB module. The GRCOP is confident these goals will be accomplished because of the investigators and staff firmly believes that what they do is critically important for present and future oncologic care. The Grand Rapids Clinical Oncology Program represents a proven resource with significant ongoing potential to serve the objectives of the National Cancer Institute's CCOP program. Convinced that our patients are better served by the availability of a strong, quality-oriented community research program, the Grand Rapids Clinical Oncology Program is committed to remaining one of the most successful CCOPs in the country, contributing significantly to oncology clinical research.